Abnormalities of the Erythron Flashcards

1
Q

What do RBCs look like?

A

Biconcave disc shape in most species giving an area of central-pallor and a high surface area to volume ratio and allows for deformability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What shape RBCs do camelids have?

A

Elliptical RBCs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How do bird and reptile’s RBCs differ?

A

They are nucleated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What do RBCs contain?

A

Haemoglobin as their function is oxygen transport

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the production sites of RBCs?

A

Liver/spleen in the foetus and then swaps to bone marrow in neonates
In growing mammals bone marrow of all bones produces RBCs in adults only femur/humerus and flat bones do

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Which organs become activated in increased demand for RBCs?

A

Liver, spleen and long bone bone marrow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the production requirement for RBCs?

A

Stem cells, space in marrow, growth factors (IL-3, GM-CSF, G-CSF erythropoietin), iron, cholesterol/lipids for membrane, enzyme pathways for construction and maintenance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How do RBCs mature?

A

Series of cells types starting with lots of cytoplasm and a large nucleus which gradually condenses and finally disappears

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the lifespan of RBCs?

A

100 days in dogs, 70 days in cats and 150 days in cattle and horses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How are RBCs removed from the circulation?

A

Phagocytic macrophages taking up senescent red cells and recycling components or intravascular haemolysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the definition of anaemia?

A

Reduction in red cell mass evidenced by a decreased haemoglobin concentration, packed cell volume, haematocrit or red blood cell concentration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is a haematocrit?

A

Gives same information as PCV but is calculated by a machine so relies on red cell count and volume and is less accurate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the red blood cell concentration (RBC)?

A

Total number of red blood cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the haemoglobin (Hgb)?

A

Total oxygen carrying capacity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the PCV?

A

Percentage of red cells in a volume of blood through a manual technique that also allows buffy coat assessment, plasma and total protein measurement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What causes a decreased red cell mass?

A

Increased loss too large or fast for compensation

Decreased production with losses not matched by production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the different ways of classifying anaemia?

A

By severity, by haemoglobin concentration, by red cell measurements or regenerative/non-regenerative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the characteristics of mild anaemia?

A

From just below normal PCV to 10% below normal PCV, may not affect animal until exercised, common in animals with long standing disease/endocrine disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the characteristics of moderate anaemia?

A

Varies between species depending on normal PCV for each, animals may show weakness or be well adapted but only if chronic, mucous membrane pallor and fast bounding pulse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the characteristics of severe anaemia?

A

PCV in lower teens downwards, pale, weak, unable to exercise, may need oxygen before diagnostic procedures, don’t fight with very anaemic cats

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How is anaemia classified by haemoglobin concentration?

A

Either normochromic or hypochromic can’t be hyper
MCHC/MCH measured on panel
Due to decreased iron/poor iron incorporation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How are red cell measurements classified?

A

Normocytic, microcytic or macrocytic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the characteristics of normocytic anaemia?

A

Erythrocytes of unremarkable size often associated with mild non-regenerative anaemia or acute haemorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What causes microcytic anaemia?

A

Red cell haemoglobin concentration determines when division stops so iron deficiency allows one more division resulting in a smaller cell with same haemoglobin concentration as a normal cell
PSS/iron deficiency/hepatic failure or Akitas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What causes macrocytic anaemia?
In regeneration seen as polychromatophils Some poodles have them Generally young cells FeLV cats/myelodysplasia/artefact of stored blood
26
How does regenerative anaemia occur?
Fall in oxygenation detected by kidneys which release erythropoietin which activates the bone arrow and takes 2-3 days for cells to appear in circulation
27
What is the indicator of regenerative anaemia?
Reticulocytes
28
How are reticulocytes detected?
Diff-Quick or Giemsa stain look larger, bluer cells called polychromatophils New Methylene Blue precipitates RNA forming aggregates/reticulum = reticulocytes
29
How do reticulocytes differ in cats?
Retics released as aggregate retics and mature to punctate retics over time Counts should record either aggregate or both
30
What is the reticulocyte percentage?
Number of retics per 1000 cells counted as a percentage
31
What is the corrected reticulocyte?
Retic% x patient PCV/normal PCV | Takes anaemia into account
32
What is the absolute reticulocyte concentration?
RBC concentration x retic%
33
What are the possible routes of external haemorrhage?
Melena, urinary tract, epistaxis, post trauma/surgery
34
What are the possible routes of internal haemorrhage?
Bleeding tumours, trauma, into tissue (bleeding diathesis), surgery
35
What are the different causes of haemolysis?
Immune-mediated, parasites, Heinz-body associated anaemia, eccentrocytes, sheer injury and inherited diseases
36
What are the signs of immune-mediated haemoytic anaemia (IMHA)?
Anti-red cell antibodies, may agglutinate, Coombs test positive, can be severe/rapid, usually strongly regenerative, ghost cells intravascularly, spherocytes extravascularly, increased bilirubin/neutrophilia/monosytosis/platelets affected
37
What parasites cause regenerative anaemia?
Mycoplasma haemofelis and M haemomimutum or Babesia
38
What are the signs of babesiosis?
Epicellular parasite with large and small forms, increased fragility and haemolysis, cycles on 3-8 week basis, diagnosis by PCR
39
What are Heinz bodies and what causes them?
Denatured haemoglobin due to oxidative injury from paracetamol, onions, Vit K, propylene glycol
40
What are eccentrocytes?
Uneven haemoglobin distribution within cell due to oxidative damage to membrane seen most often in dogs/horses with red maple toxicosis
41
What are the different inherited causes of regenerative anaemia?
Pyruvate kinase deficiency in Basenhis and Basset Hounds Phosphofructokinase deficiency in English Springers Feline porphyria
42
What are the general causes of non-regenerative anaemia?
Inflammatory/chronic disease, renal, endocrine, FeLV, non-regenerative marrow, myelopthisis, myelofibrosis
43
What are the characteristics of non-regenerative anaemia due to inflammatory/chronic disease?
Normocytic or normochromic usually mild and slowly progressing due to Fe sequestration, inflammatory mediators and shortened erythrocyte survival
44
What is the pathogenesis of renal non-regenerative anaemia?
Kidneys produce erythropoietin and in chronic renal failure production decreases
45
What are the characteristics of renal non-regenerative anaemia?
Normocytic, normochromic and mild to moderate
46
What is the treatment option for renal non-regenerative anaemia?
Can give injection of erythropoietin but can develop antibodies against it
47
What endocrine diseases can cause a non-regenerative anaemia?
Hypothyroidism and hypoadrenocorticism
48
What is the pathogenesis of endocrine non-regenerative anaemia?
Thyroid hormone and cortisol have facultative effect on red cell prodcution
49
What are the characteristics of endocrine non-regenerative anaemia?
Normocytic, normochromic, mild anaemia
50
What is the pathogenesis of FeLV non-regenerative anaemia?
Selective depression of erythropoiesis, dysplastic production and myeloproliferative disease crowding out Usually non-specific erythroid hypoplasia
51
What are the characteristics of FeLV non-regenerative anaemia?
Normocytic/macrocytic and normochromic
52
What is the pathogenesis of aplastic anaemia?
All precursor cells wiped out with only fat, plasma cells and mast cells left and need biopsy to diagnose
53
What can cause aplastic anaemia?
FeLV, oestrogen toxicity, phenylbutazone, chemotherapy and other unknown causes
54
What is myelophthisis?
Neoplasia crowding out the bone marrow resulting in an altered environment
55
What causes myelofibrosis?
Often a response to injury of fibrous elements of marrow and may be reactive following prolonged regenerative attempts
56
How is myelofibrosis diagnosed?
Core biopsy with reticulin staining of fibrous elements
57
What is erythrocytosis?
Increased HRT, RBC count and haemoglobin
58
What causes erythrocytosis?
Spurious or relative due to dehydration or RBC distribution
59
What is primary erythrocytosis?
Myeloproliferative disorder or erythoid stem cells, EPO levels normal or deceased with normal PO2
60
What causes secondary erythrocytosis?
Chronic hypoxia, EPO secreting tumours and EPO levels elevated